The unprecedented earthquake, measuring a magnitude of 8.9, which struck Japan on March 11, 2011 has plunged the island nation and the world into one of the worst nuclear crises to have ever occurred. The earthquake was the biggest on record for the country. Within 1 h, a tsunami of epic proportions hit the entire northeastern coast of Japan and left a long track of massive destruction crippling the life of millions. Among the other immeasurable losses, it has also caused serious damages to the Fukushima Daiichi nuclear power plant located in the town of Okuma in Fukushima Prefecture.

The plant houses six boiling water reactors (BWRs), which have a combined generating power of 4.7 GW. The March 11 earthquake and tsunami cut the supply of off-site power to the cooling systems of the plant. In addition, diesel generators meant for providing backup electricity to the plant's cooling system were also disabled by tsunami flooding. This resulted in pressure build-up, leading to three hydrogen explosions on March 12 (Unit 1), March 14 (Unit 3) and March 15 (Unit 2), respectively, and two fires in the spent fuel tank in Unit 4 that were put off. Prior to the explosions, venting of the containment of reactor was carried out through a controlled release of vapor that contained low amounts of radioactivity. The nuclear accident was initially labeled by the Japanese nuclear authorities as a Level 4 accident (accident with local consequences) on the International Nuclear and Radiological Event Scale (INES). In the subsequent information, no rating was given although various experts were placing it between 5 (accident with wider consequences) and the highest, which is 7 (major accident).

Authorities acted well on time and evacuated everyone within a 10-km radius from the plant to safer locations by March 12. Japan's Nuclear and Industrial Safety Agency (NISA) has reported that about 185,000 residents had been evacuated. Following the third explosion, this distance was increased to a 20-km radius circle, which was completed by March 16. According to the local government officials, 190 people have been exposed to radiation, although full details were not known. The stricken plant has sent low levels of radiation drifting into Tokyo, spreading alarm in the city and internationally.

Authorities have advised people within a 30-km radius to remain indoors and not to venture outside. They have distributed 230,000 units of stable iodine to the evacuation centers. The iodine has not yet been administered to residents and was a precautionary measure. A 30-km no-fly zone has also been enforced around the plant.

It is now estimated that 70% of the fuel rods were damaged in Unit 1 and 33% in Unit 2, although the exact nature of the damage was unknown.

Engineers at the plant are working at tremendous personal risk and are trying to bring the situation under control by pumping in seawater. Following another fire on March 16 and the surge in radiation levels to as high as 1000 mSv/h at a few locations, they had to be withdrawn from their salvage actions temporarily. The radiation levels at these locations have fallen down to about 600-800 mSv/h.

Meanwhile, the International Atomic Energy Agency (IAEA) has been constantly providing up-to-date information through its website, which largely helps to get authentic information. The IAEA continues to liaise with the Japanese authorities and is monitoring the situation as it evolves. The agency held a meeting with several other UN organizations under the framework of the Joint Radiation Emergency Management Plan of the International Organizations to discuss the developments and coordinate activities related to consequences of the earthquake and tsunami. This group is expected to work closely together in the days ahead.

The Japanese government on March 16 requested assistance from the IAEA in the areas of environmental monitoring and the effects of radiation on human health, asking for IAEA teams of experts to be sent to Japan to assist local experts.

Events happening in the next few days would decide which way the disaster would progress from now on: to worse or better. Needless to say, the entire world is watching the happenings with great concern for the people of Japan and for the entire mankind.

X-ray machine from the roentgen era compared with a modern version

An X-ray equipment developed jointly by a high school director and a hospital director in Maastricht, The Netherlands, in 1896, just weeks after the discovery of X-rays by Wilhelm Roentgen was used to produce images and analyzed by researchers of the Maastricht University Medical Center. The equipment was originally built by the directors through parts found at the high school, which included a high-voltage transformer and a glass bulb with metal electrodes at each end. They used it for anatomical imaging experiments. The machine ended up in a warehouse in Maastricht and was unearthed last year for a history programme on television.

The research team found that a radiation dose 10-times higher was required from the antiquated system compared with a modern one if a modern detector was used. If a photographic plate was used and the same imaging conditions of 1896 were followed, then the dose was higher by 1500-times. The image was blurred due to the large focal spot.

New york times once again brings the public's attention to issues related to radiation in healthcare and radiation treatment mistakes in radiotherapy

Voicing concern over children being subjected to more radiation in dentists' chairs, the article dated Nov 22, 2010 dealt in detail about the cone beam computed tomography used in dental imaging. Presenting different viewpoints from several professionals and experts, the article, among other things, points out that radiation from such a cone beam 3-D imaging can be four- to 67-times as much as conventional dental X-ray imaging. It mentions that increasing use of these scanners for monetary reasons can seriously burden the exposed population to avoidable risks.

The December 28, 2010-dated daily gave the story of the treatment mistakes happening in the stereotactic radiosurgery treatment of three patients in a hospital in the state of Illinois, USA in 2009. The American Society for Radiation Oncology (ASTRO) was quick to respond to the story with a detailed response the next day. Expressing grave concerns about the extremely rare treatment errors reported in the article, ASTRO stated that professionals in the specialty were continuously working toward eliminating the same.

The organization added that Integrating the Healthcare Enterprise-Radiation Oncology (IHERO), Target Safely campaign, federal legislation to develop a national medical error reporting system, a patient safety database for radiation oncology, strong and credible radiation oncology practice accreditation, educational program for radiation oncologists wishing to maintain their physician certification, white papers on safety and quality with a specific focus on newer technologies such as stereotactic radiosurgery and bringing out recommendations on staffing and oversight were some of the important actions taken toward this goal. It has also added patient support material in its website and public portals. Currently, ASTRO's draft white paper on Safety Considerations for Stereotactic Body Radiotherapy is open for public comment.

The New York Times published another news story on Feb 28, 2011 on X-rays and unshielded infants. In July 2007, a radiology chairman in a New York hospital wrote e-mails to his departmental colleagues expressing his anguish about how a neonate was imaged full-body ("babygram") without gonadal shielding in place. The news story was on this e-mail and other related issues like radiation dose to infants from such unacceptable procedures, competence, training and oversight of radiological technologists, continuing education requirements, accreditation of radiology units, etc.

The American Association of Physicists in Medicine (AAPM) came out with a response to the article saying that patient safety in the use of medical radiation can be increased through enacting legislation that would establish minimum education, training and experience requirements; improved and consistent accreditation processes and a national event reporting/recording system.

A news story appearing on the March 5-dated New York Times stated that despite FDA warning more than a year ago, and wide publicity about the incidences of overdose in diagnostic computed tomography scan studies, a hospital in West Virginia continued to overdose its patients who underwent brain perfusion studies. It appears that at least 20 patients received "too much" radiation. Lack of federal regulations controlling radiation exposure from medical X-ray scans is cited as one of the possible reasons for such incidences.

Are prostate patients in the us over-treated by intensity-modulated radiotherapy?

In a news item on Health Care Industry in the United States, the reputed American daily, Wall Street Journal, presented an analysis on the sharp rise in the use of intensity-modulated radiotherapy (IMRT) for prostate cancer patients. According to the news item that appeared on December 7, 2010, groups of urologists had teamed up with radiation oncologists to overtreat such patients with IMRT through referrals to centers in which they have financial interests. The newspaper also carried the version of the urologists' groups who denied the allegation.

The same point has been highlighted in another similar story appearing on Feb 28, 2011 dated The Washington Post. The article discusses in detail about the loophole in the federal self-referral law and how it is leading to perverse incentives in prostate cancer treatment.

But, scrutiny of the urology groups is mounting, spurred by the American Society for Radiation Oncology (ASTRO), which has denounced urologists' practice of referring patients for treatment in facilities they own as unethical. It is now partnering with a coalition of organizations concerned about self-referral abuses to advance legislation closing the self-referral loophole. Besides that, the U.S. Government Accountability Office is also launching a probe into the practice of self-referrals nationally that will focus in part on IMRT for prostate cancer.

Public debate on nanotechnologies in the netherlands raises awareness about the risks involved and also creates support

Science and technology are now more important for the development of a country than ever before. However, the public seems to be increasingly suspicious of scientists' work. Bt Cotton, Bt Brinjal, nuclear power, peaceful applications of radiation and vaccination campaigns are some of the examples that received more of a negative publicity than positive outlook due to public's suspicion of science and technology.

On January 27, 2011, the Dutch public's agenda on nanotechnologies, titled "Responsibly forward with nanotechnologies," was presented to the Government of The Netherlands. In this public agenda, the people of The Netherlands spoke out about their priorities for nanotechnologies research and development: what to do and what not to do, what do they fear and what do they hope for, how to balance the risks and the benefits. This public's agenda resulted from the Societal Dialogue on Nanotechnologies, held between January and November 2010.

The promised benefits of nanotechnology are large and every field of science and technology has many potential applications of nanotechnologies. However, there are possible hazards as well. There is scientific evidence of toxicity, but not yet absolute scientific certainty about nanotoxicity. Unlike in the cases of asbestos or ionizing radiation, where absolute scientific certainty about the risks exist, nanoscientists do not yet have the complete story on nanorisks.

While the dialogue extending over several months has made the general public of The Netherlands aware of the risks of nanotechnologies, it has also resulted in their increased support for further development of this technology.

Universities and academic institutions set to follow the university grants commission guidelines for procuring, storing, using and disposing radioactive and radiation-generating sources

The University Grants Commission (UGC), New Delhi has issued a set of guidelines to all universities on procurement, registering, use and disposal of radioactive sources and all types of radiation generators. The document is titled "UGC Guidelines for Universities, Research lnstitutes and Colleges for Procurement, Storage, Usage and Disposal of Radioactive and Other Hazardous Materials and Chemicals." According to these guidelines, it is now mandatory for all universities and educational institutions to obtain approval from the Atomic Energy Regulatory Board (AERB) for purchase of such sources, intent of their use and safety of the storage facility. They are also directed to maintain a proper disposal mechanism for liquid radioactive substances.

The eight-point guidelines on procurement and registration include availability of emergency response plans, trained manpower such as AERB-certified Radiological Safety Officer (RSO) who can be a faculty member with relevant experience and commitment to return spent sources to the original supplier.

Each varsity should have a University Safety Committee (USC), constituted by the Academic Council, to review the safety in handling of radioactive and other hazardous chemicals. An apex committee at the UGC level will monitor these safety committees.

The guidelines, which were approved in September 2010, have been divided into administrative mechanism, procurement and usage of radioisotopes, radiation instrument survey/reporting, disposal of radioisotopes and emergency procedures.

Source: UGC letter D.O. No. F. 10-1/2010 (CPP-II) dated 07-01-2011

Hanford continues to pose radiological contamination issues

Hanford, US's biggest environmental cleanup site occupying more than 586 miles of desert along the Columbia river, has thrown up another challenge to the agencies involved in its clean-up. One of the reactors located at this site produced plutonium for the atomic bomb dropped on Nagasaki, Japan, in 1945. Deadly radioactive contamination was recently discovered at the site and it was found to be from a waste buried 12-20 feet underground. Due to the very high levels of radiation, planning to access it without endangering personnel would take months.

Risk of eye and skin injuries from high-powered, hand-held lasers used for pointing or entertainment

The US Food and Drug Administration (FDA) has alerted consumers about the risk of eye and skin injuries from exposure to high-powered laser pointers. Such handheld devices are easily and increasingly available in the local market (in India too) and through the internet. Even at the seemingly innocuous 5 mW level, such devices can result in serious eye injury. Devices operating at a higher power level can cause irreversible eye injury.

While recognizing that there are varied and legitimate users of laser pointers, the FDA has called for precautions while using them and has given recommendations for their safe use. The recommendations include: children should not be allowed to use such devices; they should be properly labeled and not have power level more than 5mW; check devices that you possess and discard them if they are of higher power; no one should aim the laser pointer at any person, pet, vehicle or aircraft in direct or indirect manner through reflections; consult eye doctor immediately in the event of any injury.

According to a market research report, use of radiation therapy is on the rise in the US, with procedure volume growing at an average annual rate of 7%. About 1.1 million cancer patients received a course in radiation therapy during the year 2009. The report states that imaging technology is increasingly being used in radiation therapy. While almost every radiotherapy treatment plan uses computed tomography (CT) images, 12% use magnetic resonance imaging and 8% used positron emission tomography images. There are 2170 sites offering radiation treatment facilities. The report highlights another interesting point that the CT-simulator has almost replaced X-ray simulators, with two-thirds of the current installed base being CT-simulators. In the year 2003, this scenario was the reverse.

In 2009, more than two-thirds of the sites provided treatments using image-guided radiation therapy, an increase from 15% in 2004. Nearly 20% of the facilities offered stereotactic body radiation therapy in 2009, and 20% also offered cranial stereotactic radiation therapy. Almost 70% of the sites that have oncology information systems can access a patient's electronic medical records or have the complete patient record integrated as part of the healthcare IT system.

The IAEA assists its Member States in their efforts to develop effective, evidence-based interventions to combat malnutrition in all its forms by nuclear techniques. This publication was developed as an integral part of the IAEA's efforts to contribute to the transfer of technology and knowledge in the application of a widely used nuclear technique in nutrition, i.e. dual-energy X-ray absorptiometry (DXA). It provides information on the theoretical background as well as the practical application of DXA to measure bone mineral density and to assess body composition.

The current and future burden of cancer incidence in developing countries requires the planning, establishment and upgradation of radiotherapy services at the national level. This publication is a practical guide outlining the main issues at stake when planning national radiotherapy services. It provides an assessment of the cancer burden, evaluates the existing resources and determines what is needed and how to cover the gap in a resource-oriented rational way. The publication will be of practical value to decision makers and programme managers in public health facing the organization or reorganization of radiotherapy in their countries.